However you define your relationship with us, we want to be open, supportive and have clear communication with you. With this in mind, we thought it was important to address some of the current medical controversies that have been making the news recently:
- PSA tests barely reduce the rates of prostate cancer mortality (March 1, 2016 Calgary Herald) "Valuable or wasting resources?"
- Canadian Task Force Guideline: PAP tests should be done every three years. "Really, for every woman? What about risks, family history or exposures?"
- Canadian Task Force Guideline: No need for routine screening colonoscopy in healthy people "Do we then just wait for bleeding?"
What does this mean and do we at Medisys follow these guidelines around screening issues?
Well, firstly, what is screening?
In medicine, screening is a strategy used in a population to identify the possible presence of an as-yet-undiagnosed disease in individuals without signs or symptoms.
This is an important statement, and yes, this is how government and guidelines may make decisions for populations. This is NOT our role at Medisys. We are not screening a population in a cost effective way for any government. Rather we are providing one-on-one care for you as an individual. When we chose to do certain tests, colonoscopy for example, we are doing “targeted case finding”, not mass screening. And we make that decision based on you: you age, your family history, your symptoms or lack of symptoms, your concerns and your history. This is personalized medicine at its best, not “screening”
So do we follow guidelines at Medisys. Absolutely yes, we are aware, educated and take these recommendations very seriously. But guidelines do not make decisions for us as doctors. Rather they reflect some issues and we cognizant of the questions, reflect on the issues and make a case by case recommendation.
Our role is to partner with you, integrating both clinical judgement and evidence in order to dispense the best clinical care as your health care provider.
So do you need a PSA? Should you have a routine colonoscopy? How often should we do a PAP test for you? Come and talk to us, and we will make these and other decisions together.
And always remember:
"Neither evidence nor clinical judgment alone is sufficient.
Evidence without judgment can be applied by a technician.
Judgment without evidence can be applied by a friend.
But the integration of evidence and judgment is what the healthcare provider does in order to dispense the best clinical care."
Hertzel Gerstein, 2012